Imposed and chosen monitoring and blunting strategies in the dental setting: Effects, self-efficacy, and coping preference

Abstract

In the present study, 94 dental patients received either monitoring (i.e., paying attention) or blunting (i.e., distraction) coping instructions during treatment. Half of the patients were given the possibility of choice, whereas the other half were offered one of both strategies without choice. A majority of the patients (n=61) indicated that the intervention had resulted in a decrease of their anxiety. Some indications were found for the monitoring strategy to be more effective than the blunting strategy. More specifically, monitoring strategy subjects reported that they had experienced less distress during treatment than blunting strategy subjects. In agreement with this finding, self-efficacy ratings of monitoring strategy subjects were higher than those of blunting strategy subjects. Possibility of choice and coping preference had no substantial influence on effectiveness of the interventions.

Clinical management of dental anxiety: what works for whom?

“…Experimental research supports the hypothesis that in particular people who have a strong need for control, but who are denied this, interpret the dental situation as fearful 8 . This is why it is important to ensure that the patient feels a participant in his/her treatment and is able to have some control over it by temporarily interrupting treatment, for example by using a previously agreed hand signal (Stop/start signal) 9 .…”

“…The experimental research literature indicates that allowing for treatment to be highly predictable in relation to anticipated experiences, including negative sensations (sensation information) is one of the most effective components of an anxiety reduction programme [10][11] . For example, it has been found that procedures whereby the patient is continually kept informed about the treatment appear to have a significantly more positive effect on the level of pain and anxious tension (state anxiety), than the use of the stop signal, the use of simple visual distraction (such as studying complex visual, Escherlike posters) or listening to guided imagery presented via earphones 9 . However, it should be noted that there are indications that sensation information has a detrimental effect on the mood of non-anxious patients 10 .…”

Dental Anxiety - Definition, Etiology, Diagnosis and Treatment Options

“…In a study that looked at individuals who had a need for control, they found that when these individuals did not feel like they had control, they often felt that their dental treatment was fear evoking [33]. The establishment of hand gestures that indicate when to start and stop a dental procedure, has been shown to be an effective option for patients who need control [34]. Regardless of if the patient needs control or more predictability, it is the dentist's job to make this assessment.…”